Comments
1

"The authors report their experience of SWL in a paediatric population and present some factors that can be used to predict the treatment outcome. Although the stone burden (in study only expressed by the largest diameter of the stone) and stone location are well recognized determinants of SWL results, the outcome in children usually is superior to that in adults. The pre-requisite for that is that the stones are satisfactorily disintegrated. It is of note that in as many as 22% of the children sedatives + analgesics rather than general anaesthesia was used. It is not known if this affected the treatment result, but it is my own experience that in most children it is difficult or impossible to carry out and appropriate SWL without general anaesthesia.

Perhaps the stone-free rates could have been better and the need of repeated treatment sessions reduced by a longer interval between the sessions, because fragment clearance should be much better than what we are used to see in adults. This is an effect of the more powerful ureter in children."

Please refer to comments for article El-Nahas et al. Int J Urol 2013:
"The authors report their experience of SWL in a paediatric population and present some factors that can be used to predict the treatment outcome. Although the stone burden (in study only expressed by the largest diameter of the stone) and stone location are well recognized determinants of SWL results, the outcome in children usually is superior to that in adults. The pre-requisite for that is that the stones are satisfactorily disintegrated. It is of note that in as many as 22% of the children sedatives + analgesics rather than general anaesthesia was used. It is not known if this affected the treatment result, but it is my own experience that in most children it is difficult or impossible to carry out and appropriate SWL without general anaesthesia.
Perhaps the stone-free rates could have been better and the need of repeated treatment sessions reduced by a longer interval between the sessions, because fragment clearance should be much better than what we are used to see in adults. This is an effect of the more powerful ureter in children."
Hans-Göran Tiselius